Life Insurance Corporation of India

PCMC, Network Operating Center

1st Floor, Jeevan Seva Annexe
S.V.Road, Santacruz(W)
Mumbai - 400 054
PREMIUM PAID CERTIFICATE FOR THE YEAR 2014-2015
DATE OF ISSUE: 08/01/2015
This is to certify that the following premium have been received under the following life
insurance policy held by Maghadeswari Ramajayam Nadar
Name
Policy Number

Maghadeswari Ramajayam Nadar

907581593

Plan

165(Jeevan
20
20
10/09/2012
255.00
MLY
91314773

Policy Term
Premium Paying Term
Commencement Date
Instalment Premium
Mode Of Premium Payment
Reference Code

Number Of
Instalments
04/2014 1
05/2014 1
06/2014 1
07/2014 1
08/2014 1
09/2014 1
10/2014 1
11/2014 1
12/2014 1

Due From Due To

04/2014
05/2014
06/2014
07/2014
08/2014
09/2014
10/2014
11/2014
12/2014

Premium Amount
Received
255.00
255.00
255.00
255.00
255.00
255.00
255.00
255.00
255.00

Saral)

Received
Date
15/04/2014
15/05/2014
16/06/2014
15/07/2014
16/08/2014
15/09/2014
16/10/2014
15/11/2014
15/12/2014

Collecting
Branch
E089
E089
E089
E089
E089
E089
E089
E089
E089

Status
Normal
Normal
Normal
Normal
Normal
Normal
Normal
Normal
Normal

Total amount received towards premium for the policy number 907581593 is Rs. 2,295.00 for
the financial year 2014-2015

This certificate is electronically generated